Ultrasound scanning guidelines
Acute Paediatric Abdomen
If a request is received for acute abdominal pain and the area is vague and non-specific, a full assessment of the abdomen is required. This is also the case with babies and younger children when we are unable to get a verbal indication of the region of the pain and clinical assessment may be difficult.
Assess:
- Upper Abdomen
- pancreas
- aorta
- gallbladder/duct
- liver
- kidneys and adrenals
- spleen
- Large bowel (to rule out intussusception) - ascending, transverse, descending colon and rectum
- RIF/appendix
- SMV/SMA relationship
- Mesentery (for lymph nodes)
- Bowel wall (for thickening)
Documentation:
Upper Abdomen
- transverse pancreas
- long aorta
- gallbladder - long and trans (include wall thickness)
- bile duct calibre
- Liver - long and trans views
- adrenals - long and trans views of both
- kidneys - long and trans views of both
- spleen - long and trans views
Large Bowel
- trans and long vies of
- ascending colon
- transverse colon
- descending colon
- rectum
- long midline view of Pouch of Douglas
- trans and long views of terminal ileum, including wall thickness measurement
- colour Doppler of affected bowel
If intussusception seen
- At intussusception site:
- trans view + - clipstore
- long view + - clipstore
- trans view with colour Doppler
Appendix / RIF
- long appendix
- trans appendix with diameter measurement - with/without compression
- pelvis long for free fluid
- non-compressible appendix +/- clipstore of compression
SMV/SMA relationship
- trans SMV/SMA view +/- colour Doppler
Mesentery
- trans and long views of mesentery
- document and measure any lymph nodes seen > 5mm in diameter
- Assess lymph nodes with colour Doppler
- intanodal blood flow and some blodd flow in the rissues between the nodes may be seen
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